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The 1915(b) waiver program in that state uses a primary care case management (PCCM) system in which Medicaid enrollees have all of their health care services coordinated by one physician. The PCCM process allows greater access to preventative as well as ongoing care that, the state reports, has lowered the inappropriate use of expensive emergency room visits.

"Using case managers to assure continuity of care puts those with low incomes on a level playing field when it comes to access to proper health care," said Thompson. "It allows health conditions to be treated before they become emergencies and people end up much sicker and in an expensive emergency room setting. I am pleased to renew Pennsylvania's program."

Local beneficiary surveys show that the over 8,000 beneficiaries participating in the case management program are pleased with the care they are receiving. The state reports to HCFA that the program has saved nearly $6 million over what Medicaid for this group would have cost in the absence of the waiver.

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